OP-ED

Angry Nurses Tell of Ebola Patient’s arrival at Texas Hospital

Texas Health Presbyterian

A group of nurses at Texas Health Presbyterian has come forward with a very different picture of what happened when Liberian Ebola patient Thomas Duncan arrived at the hospital with Ebola-like symptoms on September 28th.  If true, the allegations are certainly unsettling.

In an unusual move, the nurses spoke anonymously to the media, conducting a blind conference call in which none of the participants were identified.

After arriving at the emergency room with a high fever and other symptoms of the disease , the nurses said the patient was kept in a public area, despite the fact that he and a relative informed staff that he had been instructed to go to the hospital after contacting the Centers for Disease Control in Atlanta to report a possible case of Ebola.

The nurses said the patient was  “left for several hours, not in isolation, in an area” where up to seven other patients were. “Subsequently, a nurse supervisor arrived and demanded that he be moved to an isolation unit, yet faced stiff resistance from other hospital authorities,” they alleged.

Duncan’s lab samples were sent through the usual hospital tube system “without being specifically sealed and hand delivered. The result is that the entire tube system … was potentially contaminated,” they said.

The statement described a hospital with no clear rules on how to handle Ebola patients, despite months of alerts from the Centers for Disease Control and Prevention in Atlanta about the possibility of Ebola coming to the United States.

“There was no advanced preparedness on what to do with the patient. There was no protocol. There was no system. The nurses were asked to call the infectious disease department” if they had questions, but that department didn’t have answers either, the statement said. So nurses were essentially left to figure things out on their own as they dealt with “copious amounts” of highly contagious bodily fluids from the dying Duncan while wearing gloves with no wrist tapes, flimsy gowns that did not cover their necks, and no surgical booties, it alleged.

The charges come on the same day as news that a second healthcare worker has tested positive for Ebola. Frieden said public health officials should prepare for the worst, saying that it is likely that more cases will emerge.

The CDC Director issued a series of statements yesterday admitting that the agency was slow in responding to the crisis. Frieden backtracked on statements that many nurses interpreted as throwing the nurses involved under the bus. The agency is reassessing its guidance on the disease.

Nurses and their supporters took to Twitter to defend the nurses involved.

Screen Shot 2014-10-15 at 10.17.46 AM

Note: You can read the CDC’s original guidance to health care workers  in Frieden’s THCB blog post here.

Update : Revised guidelines call for extra precautions to be taken to cover exposed skin, second layer of gloves.

New Ebola PPE

If you are a nurse involved in the care of a patient at Texas Health Presbyterian, we’d like to hear your side of the story. E-mail us.  We’re also interested in hearing from other nurses around the country. Has your hospital established procedures and guidelines for dealing with potential Ebola cases?

Pick up the story from the Dallas Morning News here

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bu blogCurly Harrison, MDWhatsen WilliamsMD as HELLGina Davis Recent comment authors
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bu blog
Guest

This is a really good tip particularly to those fresh to the blogosphere.
Short but very accurate information… Thanks for sharing this one.
A must read article!

Curly Harrison, MD
Guest
Curly Harrison, MD

Vendors know that they are not to sell medical devices without FDA approval. How it came to be that EHR, CPOE, and CDS are being used to diagnose and treat disease without approval by the FDA is a matter for investigation.

Those who have allowed this, giving the vendors of EHRs a pass from oversight, have Mr. Duncan’s blood on their hands.

Whatsen Williams
Guest
Whatsen Williams

The facts indicate that the EHR was true to form, causing errors that would never have occurred with the highly evolved safety net that was replaced by the user unfriendly, time consuming, flawed EHR.

Allan
Guest
Allan

What makes John think that Kincannon was speaking for the Tea Party? Oh, he made that up. …and he also made up the claim about his annoyance over the comments being made and how the thread refuses to die. If he wanted the thread to die he would have not written such nonsense.

We wait to hear why what Senegal did to become Ebola free is so wrong.

John Ballard
Guest

This thread refuses to die. Every day I delete notices from my inbox for yet another bunch of comments at this post. Most are spam (which keep the blog moderators busy) but many are just ongoing yammering. Please, folks, put a sock in it. Give it a rest. Some here may have a bright futures asTea Party activists, like South Carolina’s Todd Kincannon.
http://aattp.org/pro-life-tea-party-christian-todd-kincannon-execute-all-ebola-patients-screenshots/
I came across a new twist on an old axiom — You can show some folks the facts but you can’t make them think.
If the shoe fits… you know the rest.

John Ballard
Guest

There may be a polar vortex in Hell because I am compelled to say say Thank you to National Review Online and Shep Smith of Fox News. Anyone familiar with my politics (unreconstructed Sixties Liberal) knows I have a deep-rooted antipathy for both. But it’s only right to recognize when they get something right. The link is easy to find. Read for yourself as they point out something blindingly clear: Despite the fever-pitch nature of televised Ebola coverage, there are exceptions. On Fox News, anchor Shepard Smith went out of his way to provide context for a reporter’s conclusion that… Read more »

Allan
Guest
Allan

You might be right John that there is a polar vortex because I am compelled to agree with you. I think that some of the louder voices don’t disagree either except rightfully they believe the border should be shut/controlled with regard to non American citizens from the hotspots of those nations. We have the facilities to manage Ebola once we get our act together. Look at the havoc one Ebola patient caused. Disruptions to the airline industry and all the industries downstream can have a similar effect. School closures in the areas. Hundreds of people in isolation. A major hospital’s… Read more »

Gina Davis
Guest
Gina Davis

Since the U.S. can’t get their act together, perhaps we should find some real health care professionals (from Africa) who are equipped to work with ebola patients, to train our U.S. staff. Since September all the nightly news channels have been showing how “suited” up the African healthcare workers are and how something as simple as washing your hands, etc – can kill the virus. Why the nurse would board a plane – even with a low grade fever – after having worked around Mr. Duncan, I don’t care what the CDC told me – I would not expose my… Read more »

@BobbyGvegas
Guest

“Sadly, it has reached the point where we will not feel safe unless we ban travel to and from Liberia, Sierra Leone, and Guinea. The reason this is a sad moment is that there is a good chance it could interfere with the flow of health care and resources to and from these countries. Not only that, but, historically, when a country suffering from a growing epidemic has felt cut off from the rest of the world, the fear quotient has risen, and people afraid of the contagion have attempted to flee. Unfortunately, when people hastily attempt to escape imposed… Read more »

Allan
Guest
Allan

Seigel is taking an all or none view of the situation. I have heard him before and he becomes flummoxed when others explain a ban need not exist as charter flights and military aircraft could be used. Isolation could also be a solution and is presently being used in the US with American citizens that have become exposed to the virus. No one can predict the future so one should be cautious and recognize that each case causes many Americans to face isolation, hospitals to close their doors and send ambulances elsewhere along with immense amounts of spending that could… Read more »

Peter1
Guest
Peter1

Governor Rick Perry is now calling for a travel ban. I agree, we should not let Texans travel outside the state since their medical system is incapable of containing their “outbreak”.

Barricades should be placed at all roads crossing state lines, air travel should be blocked from leaving texas and train service outside the state ended. Since cows may contract the disease no Texas beef should be sold outside the state.

Better to take necessary precautions than panic.

Allan
Guest
Allan

Peter1, we are not discussing persons that have little to no risk. We are talking about real risk and real lives. As stated below Doctors Without Borders has lost 9 of their staff and have 16 infected.

Peter1
Guest
Peter1

Allan, you and the frantic Right (pre Nov 4) are calling for travel restrictions based on nothing but location, location, location – no matter the risk.

How do you know what risk is posed by the Ebola State – Texas? Don’t you want zero risk?

Allan
Guest
Allan

Peter1, it is not the true conservative right that requires zero risk rather the left that almost always uses anecdotes to prove a point. Zero risk cannot be obtained, but one can attack the bulk of the risk and that is what it seems you fail to understand. This has nothing to do with politics. It only has to do with common sense. The third world nation of Senegal will shortly be considered Ebola free followed by the third world country of Nigeria. How did they do that with their third world technology? They sealed their borders and intensively followed… Read more »

Peter1
Guest
Peter1

“Politics is dominating common sense and it is dulling the intellect of those that suck it up.”

“This has nothing to do with politics.”

?

Allan
Guest
Allan

Peter1, a well known and well practiced proven methodology is not political. What is political are your accusations. What is the evidence that the above is not the best way to protect this nation? You don’t have any. The reason Obama has decided to do what he has done is for political reasons and that might be rational, but his rational that we don’t want to make the people feel trapped is not well grounded for the nations surrounding the hotspots have sealed their borders and two will soon be considered Ebola free. We must protect our resources to protect… Read more »

Peter1
Guest
Peter1
Allan
Guest
Allan

You totally miss the point. I provided a methodology and you provided an editorial that is talking about the rhetoric being used. That is a typical ideological response by one that doesn’t have an answer. What is wrong with the methodology I presented? What is wrong with the methodology used by Senegal and Nigeria that are becoming Ebola free? You don’t have an answer so you post an editorial that is not on point. We don’t know if we will have another case or not. What we do know is that one case has caused hundreds to be cautioned, two… Read more »

Peter1
Guest
Peter1

Tell you what Allan, if Canada has an epidemic of Ebola I’ll support a travel ban.

Allan
Guest
Allan

Peter1 writes: “Tell you what Allan, if Canada has an epidemic of Ebola I’ll support a travel ban.”

Typical low level thinking of leftist ideology on many fronts.

Allan
Guest
Allan

Bobby, it appears that Duncan knew he was probably infected and what did he do? Where is the best technology and care to prevent death from this disease? The US.

Duncan a trained individual hopped a plane to the US. People that are dying will do a lot to remain alive.

Gina Davis
Guest
Gina Davis

Too bad Duncan was wrong in his assessment of “getting good care” in the U.S.

Allan
Guest
Allan

The death rate from this strain of Ebola is now said to be around 70% and that doesn’t count the deaths that never make it to be counted. We will be able to judge how good American care is when we see how many of those that get Ebola die. Hopefully the number will not be statistically significant. What country has put in more dollars than the US in trying to find a vaccine and/or a cure? Can you tell us the answer? What was wrong with Duncan’s care? What was wrong was the care for others around him. That… Read more »

Allan
Guest
Allan

Allan says: October 16, 2014 at 7:23 am Peter1 writes: “Show me. And whose politics” Plain generic politics. It is stupidity when one places national security and the security of the American people at jeopardy because of politics. You want proof. I provided some below in a list that states some of the errors, but the real proof is at the CDC where one can read how level 4 pathogens are supposed to be handled. http://www.cdc.gov/biosafety/publications/bmbl5/bmbl5_sect_iv.pdf http://www.cdc.gov/training/quicklearns/biosafety/ Those are the rules the CDC sets for itself and they are dealing mostly with pathogens that are in petri dishes, not generally… Read more »

Allan
Guest
Allan

Why is this above comment awaiting moderation? Allan says: Your comment is awaiting moderation. October 16, 2014 at 7:23 am Peter1 writes: “Show me. And whose politics” Plain generic politics. It is stupidity when one places national security and the security of the American people at jeopardy because of politics. You want proof. I provided some below in a list that states some of the errors, but the real proof is at the CDC where one can read how level 4 pathogens are supposed to be handled. http://www.cdc.gov/biosafety/publications/bmbl5/bmbl5_sect_iv.pdf http://www.cdc.gov/training/quicklearns/biosafety/ Those are the rules the CDC sets for itself and they… Read more »

John Ballard
Guest

Deborah Peel TED backstory.
About twenty minutes.
Pretty unsettling.
http://youtu.be/rRkGTNnEHk0

@BobbyGvegas
Guest

Yeah. But it has nothing to do with her elsewhere recent assertion that Epic EHR caused the Texas Duncan Ebola death. Moreover, her claims (~13.00-ish) regarding the safety of paper charts is overstated.

@BobbyGvegas
Guest

I think John has thrown in the towel on this thread. Where’s the post on Deborah Peel’s indictment of EHRbola?

Saurabh Jha
Guest
Saurabh Jha

“Ebola is becoming the new Benghazi”

The blame insanity is strikingly bipartisan in this country.

Allan
Guest
Allan

That is the difference between thinkers and dreamers.

Saurabh Jha
Guest
Saurabh Jha

Everyone thinks he is a thinker these days. This is the curse of a rational society. Except what we think is “thinking” is merely post hoc justification of our priors.

See my last response to BG.

Allan
Guest
Allan

That is true, but when one’s political opinions appear more faith based or similar to religion we know the thinking process has been turned off.

Post hoc justification is common and we have been seeing a lot of that lately. That is a part of the nature of man.

Saurabh Jha
Guest
Saurabh Jha

You should read Ortega’s Revolt of the Masses.

Or this book review which applies Ortega’s insight.

http://www.newenglishreview.org/custpage.cfm/frm/96531/sec_id/96531

Allan
Guest
Allan

Saurabh, thank you, but it doesn’t seem to me that the address you provided is the address you wanted me to read.

Saurabh Jha
Guest
Saurabh Jha

It was! To illustrate that public institutions are not value neutral, but depend on the wish of the public (the masses).

Allan
Guest
Allan

Absolutely! He is so right.

That is a reason we are a Constitutional Republic. That is the difference between the American and the French revolutions. The masses despite their education, class, or whatever in a democracy can with 51% of the vote, vote the other 49% into slavery.

In any event thank you for bringing up his name and thoughts which are somewhat buried in history.

MD as HELL
Guest
MD as HELL

That is in the coverage machine. The coverage asks the usual pundits the usual blame questions and they get the comments for the momentary news cycle.

John Ballard
Guest

In some ways l’affaire Ebola illustrates political polarization more than any medical or scientific questions. The facts are neither obscure nor insurmountable. Records of hemorrhagic fevers go back many years, but this time it appears that something about what we like to call progress has allowed it to get out of control. I’m reminded of fire-retardant chemicals that cause cancer in children’s pajamas and new toxic vapors for fire-fighters. And that reference to the Ellis Island hospital surrounded by water reminds me of the president’s image of a moat on the Southern border — with alligators. I have no idea… Read more »

Vik Khanna
Guest

There should be NO Surgeon General. The position is an anachronism has not been occupied by a physician with integrity since C. Everett Koop.

@BobbyGvegas
Guest

Hashtag #Obola, move over for hashtag #ObolaEHRGhaziGate.

Saurabh Jha
Guest
Saurabh Jha

You are a funny chap! For the sake of balance, we need irreverence on the right as well

@BobbyGvegas
Guest

The Power of Photoshop Compels Me…

http://www.bgladd.com/BenGayZi.jpg

Wait ’til you see my ObolaAir Presidential 747.

Saurabh Jha
Guest
Saurabh Jha

Nice one!

I think we all need to take ourselves less seriously to think with more clarity.

@BobbyGvegas
Guest
Peter1
Guest
Peter1

:>D

MD as HELL
Guest
MD as HELL

You left off the golf club and the cigarette.

Peter1
Guest
Peter1

Above is lame attempt at a smiley.

Allan
Guest
Allan

John, this isn’t “progress” it is pure politics by a President that is out of his league. The way one can prove this is by reading the CDC manuals. I posted two http’s for the CDC. One can also prove this by watching the videos of the President and listening to the videos of Frieden. They contradict themselves, each other, their underlings, common sense and the CDC procedures. Ellis island was intended to prevent disease from spreading into America. It wasn’t a political plot and it wasn’t an image. It was reality, something seemingly lost in your dreamy musings. All… Read more »